Interaction between Ropivacaine and Amiodarone
Moderate Synergy

ID DDInter1620 and DDInter76
Interaction Amide-type local anesthetics may have additive cardiac effects (e.g., bradycardia, chest pain, heart block, arrhythmias, ECG abnormalities, cardiac arrest) with class III antiarrhythmic agents.
Management Patients treated with class III antiarrhythmic agents (e.g., amiodarone, dofetilide, ibutilide, sotalol) should be under close surveillance during administration of amide-type local anesthetics. ECG monitoring should be considered.
References
Alternative for Ropivacaine N01B
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Alternative for Amiodarone C01B

Potential Metabolism Interactions

Substrate-Substrate Interaction:If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction:Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction:Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.